May is Mental Health Awareness Month. It’s Time to Shed Light On the Psychological Impacts of Hunger.

In Isiolo County, Kenya, a baby named Clinton was abandoned and left for dead by his mother, who was struggling with mental health concerns and addiction. Clinton’s grandmother, Mary, found him just in time. Alone, Clinton had been eating dirt. Community Health Promoters, trained by Action Against Hunger, screened Clinton for malnutrition and quickly put him on a treatment plan and gave him ready-to-eat therapeutic foods.

Stories like Clinton’s are more common than you might think. While it might not routinely make headlines, psychological distress can be both a driver and consequence of food insecurity. This May, during Mental Health Awareness Month, we are highlighting the complex connections between mental health and hunger, and how we’re working to help.

Mental Health and Hunger: A Cause and a Consequence

Chronic hunger can take a psychological toll. A literature review found that exposure to food insecurity is associated with psychological distress, from anxiety to mental and emotional instability. Young adults who reported being food insecure were at higher risk of developing depression, anxiety, or panic disorders. A lack of good nutrition can exacerbate challenges with mood and energy levels, creating a negative cycle.

Action Against Hunger has contributed important insights to this field of research, like our analysis of mental health and hunger in Sierra Leone. Our surveys revealed that food insecurity was the number one cause of mental health distress among young people there.

Conversely, mental health challenges can contribute to malnutrition in a number of ways. Depression and anxiety can diminish appetite. Psychological challenges such as depression can make it more difficult for people to engage in income-generating activities, resulting in food insecurity for the entire family. Poor mental health also can make it harder for caregivers to look after loved ones, which can contribute to increased hunger among children like Clinton — as well as any dependent elders or disabled household members.

The complex interplay between hunger and mental health can be exacerbated other factors, including:

• Lack of access to care: In many places, psychological support is not available. Where it is, it can be expensive and is often concentrated in urban settings, making it difficult for low-income, rural communities to access mental health services.
• Stigma: Even if mental health care is available, the topic remains comparatively taboo in many parts of the world, making it difficult for people to acknowledge that they need help.
• Gender inequality: In many places, women and girls have less access to education and lower income, while also being at extreme risk for gender-based violence. These issues negatively impact mental health.
• Emergencies: From conflicts to natural disasters, humanitarian crises are traumatic and pose mental health risks. These crises are also associated with higher rates of hunger, creating a negative cycle.
• Climate: A growing body of literature suggests that the climate crisis itself is negatively impacting mental health.

These are complex issues with no easy answers. But, it is possible to make a meaningful difference.

Taking Action

To provide evidence-based care, we start by identifying risk factors and conducting research into local contexts. We pilot programs that offer a variety of mental health support, often alongside health and hunger programs. We also ensure that our emergency response efforts include psychological first aid.

Understanding the need

To better understand mental health needs and the relationship between chronic hunger and psychological distress, we conduct mental health surveys in many parts of the world. Research led by Action Against Hunger in the Central African Republic revealed that 75% of parents of malnourished children presented symptoms of post-traumatic stress disorder (PTSD) linked to exposure to violence. As a result, parents with PTSD may struggle to care for their children, which is particularly dangerous for babies growing up in poor and potentially unstable environments.

Action Against Hunger also created and deployed a mental health needs assessment in Iraq, which illuminated the need for greater mental health infrastructure. During the time of assessment, local hospital admission data showed that 30% of patients presented with moderate or severe depression, 14% with anxiety disorders, and 15% with psychotic disorders. These insights can help develop plans to strengthen health systems.

Piloting mental health interventions

Action Against Hunger has launched programs such as Adolescent Friendly Spaces that utilize a peer-to-peer model to normalize mental health support. The program has been extremely successful. For example, in Sierra Leone, 95% of participants showed improvements in well-being.

In Afghanistan, Action Against Hunger launched an innovative hotline to provide mental health and psychosocial support free of charge. The service is staffed by around a dozen counsellors trained in psychological interventions, including suicide risk mitigation. In many ways, the hotline is a lifeline for women and rural residents, many of whom are dealing with extreme isolation in addition to hunger and other issues. We have delivered more than 2,069 sessions since the hotline opened.

Delivering mental health first aid

Refugees often are coping with significant trauma, putting them at heightened risk for both psychological distress and malnutrition. Action Against Hunger provides mental health support alongside nutrition programs in countries in conflict, such as Ukraine and Yemen, or with large refugee populations such Uganda and Colombia.

Around the world, we organize support groups for refugees, often focusing on expectant and new mothers, who are at particular risk. For example, in Nguenyyiel, Ethiopia, a community with nearly 405,000 refugees, we have created over 200 maternal support groups that offer workshops on breastfeeding, hygiene, nutrition, and stress management in addition to providing women with community and opportunities to share their past experiences.

“A new lease on life”

Program participants are not the only ones at risk for psychological distress. As part of their jobs, humanitarian workers face challenges that range from security risks to bearing first-hand witness to unspeakable suffering. That’s why we also provide psychological support for our staff and partners, too.

The good news is that this approach has proven effective in addressing mental health and hunger, too.

After only a month, Clinton’s condition seriously improved. His grandmother Mary was scheduled for counseling sessions and learned about nutrition and hygiene. “I was trained on how to feed Clinton and ensure his nutrition levels remain high. I feed him beans, milk, fruits, potatoes, eggs, and other traditional vegetables,” she said. “Hunger can actually kill.”

Now, at two years old, Clinton is a healthy toddler. His weight has been restored, he’s grown a lot taller, and he’s becoming quite talkative and energetic. Mary regularly shares what she’s learned with other caregivers at a Mother-to-Mother support group. She also tends a kitchen garden where she has planted healthy and nutritious vegetables.

When she’s not there, she can be found on the couch with her grandson in his favorite spot: her lap. To little Clinton, it’s the safest place in the world. Whenever Mary sits down, he quickly cuddles close and babbles to her using all the words he’s learned so far. Mary said, “My grandson has a new lease on life.”